BLAZE KOTLAROVSKI - Pharmacist License in Illinois | # 049062707

BLAZE KOTLAROVSKI

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062707

License Status

NOT RENEWED

Business

N

First Name

BLAZE

Last Name

KOTLAROVSKI

Business Name

BLAZE KOTLAROVSKI

Original Issue Date

12/20/1974

Effective Date

12/20/1974

Expiration Date

01/01/1997

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005